- LA Care Health Plan (Los Angeles, CA)
- Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
- Insight Global (Los Angeles, CA)
- …by management: * Write determination letters regarding the outcome of non- clinical reviews/claim denials and send to the applicable participant/provider. Correspond ... by the examiners or Participant Services Representatives when necessary. * Assist Appeals Coordinator with preparation of Benefits Committee appeal cases. * Develop… more
- State of Colorado (Golden, CO)
- CORRECTIONAL, YOUTH, OR CLINICAL SECURITY SUPERVISOR III Summit Youth Service Center Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4604637) Apply CORRECTIONAL, YOUTH, OR CLINICAL SECURITY SUPERVISOR III Summit Youth Service… more
- Healthfirst (NY)
- …+ Experience in clinical practice with a focus in appeals & grievances , claims processing, utilization review or utilization management/case ... of cases and makes critical decisions + Focuses on clinical criteria for expedited cases + Helps standardize and...for expedited cases + Helps standardize and optimize how Appeals and Grievances are routed + Determine… more
- State of Colorado (Pueblo, CO)
- Occupational Therapist Supervisor - Therapist IV Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4506134) Apply Occupational Therapist ... Supervisor - Therapist IV Salary $98,000.00 Annually Location Pueblo,...care in groups or individualized treatment sessions + Provide clinical and administrative supervision to OT staff providing OT… more
- State of Colorado (Golden, CO)
- CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER II- Golden Peak Overnight Front -End Shift Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4668112) Apply CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER II- Golden Peak Overnight Front -End… more
- State of Colorado (Golden, CO)
- CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER I- Golden Peak Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4668039) Apply CORRECTIONAL, ... YOUTH, OR CLINICAL SECURITY OFFICER I- Golden Peak Salary $2,168.00 Biweekly...in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional… more
- The Cigna Group (Bloomfield, CT)
- …related issues, implications and decisions. The Case Management Analyst reports to the Supervisor /Manager of Appeals and will coordinate and perform all appeal ... in Medicare Part C + Ability to differentiate different types of requests Appeals , Grievances , coverage determination and Organization Determinations in order to… more
- State of Colorado (Colorado Springs, CO)
- …+ 1 - 2 years + Less than a year 03 How many years of experience do you have as clinical supervisor ? + 2 or more years + 1 - 2 years + Less than a year 04 How ... of health care including physical, psychiatric, and dental maintenance. Clinical Management: Functions as the facility responsible health authority (RHA).… more
- State of Colorado (Denver, CO)
- …youth, in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional, or ... with the written program. Recommend any modifications of program to supervisory and/or clinical staff. Facilitate and monitor the cleanup of living units and rooms,… more
- WellSpan Health (York, PA)
- …+ Resolves simple or informal complaints and refers formal grievances or appeals to appropriate officials. + Intercedes with supervisor on behalf of team ... all Technician level tasks. + Provides feedback to Logistics & Distribution Supervisor on co-worker's performance. Provides input to supervisor for performance… more
- Beth Israel Lahey Health (Westwood, MA)
- …information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles and ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more